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Heart Failure VI: Adjunct Therapies01:22

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Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
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Chronic obstructive pulmonary isease (COPD) involves a group of progressive lung disorders characterized by persistent airflow limitation and chronic respiratory symptoms. Asthma-COPD Overlap Syndrome (ACOS), encompassing features of both asthma and Chronic obstructive pulmonary disease (COPD), is a group of progressive lung disorders that includes chronic bronchitis, emphysema, and refractory (non-reversible) asthma. ACOS leads to complex clinical presentations that combine the inflammatory...
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Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
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Tuberculosis, or TB, is a bacterial infectious disease caused by Mycobacterium tuberculosis. While its primary impact is on the lungs, leading to pulmonary tuberculosis, it can also affect various other organs, a condition referred to as extrapulmonary tuberculosis.
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Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
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Related Experiment Video

Updated: Feb 6, 2026

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Corticosteroids as an adjunct to tuberculosis therapy.

Charlotte Schutz1,2, Angharad G Davis1,2,3,4, Bianca Sossen1,2

  • 1a Wellcome Centre for Infectious Diseases Research in Africa , Institute of Infectious Disease and Molecular Medicine , Cape Town , South Africa.

Expert Review of Respiratory Medicine
|August 24, 2018
PubMed
Summary

Corticosteroids show benefit for specific tuberculosis types in HIV-1 uninfected individuals but carry risks. They are beneficial for managing HIV-tuberculosis immune reconstitution inflammatory syndrome.

Keywords:
Tuberculosiscorticosteroiddrug therapytuberculous meningitistuberculous pericarditis

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Area of Science:

  • Immunology
  • Infectious Diseases
  • Pharmacology

Background:

  • Inflammation significantly contributes to tuberculosis mortality.
  • Host-directed therapies modulating the immune response are gaining interest as adjuncts to antibacterial treatment.
  • The role of corticosteroids in tuberculosis management has been under-examined.

Purpose of the Study:

  • To review the efficacy and safety of adjunctive corticosteroid therapy in tuberculosis.
  • To evaluate the impact of corticosteroids in different tuberculosis manifestations and HIV co-infection status.
  • To assess the role of corticosteroids in managing immune reconstitution inflammatory syndrome in HIV-tuberculosis.

Main Methods:

  • Literature search of randomized clinical trials, systematic reviews, and current guidelines.
  • Evaluation of evidence for corticosteroid use in meningeal, pericardial, and other forms of tuberculosis.
  • Analysis of safety data, including opportunistic malignancies and immune reconstitution inflammatory syndrome.

Main Results:

  • Corticosteroids demonstrated benefit in meningeal and pericardial tuberculosis for HIV-1 uninfected individuals.
  • Evidence of benefit was less pronounced in HIV-1 coinfected individuals.
  • Harm, including opportunistic malignancy, was observed in those not on antiretroviral therapy; however, corticosteroids aided in managing paradoxical HIV-tuberculosis immune reconstitution inflammatory syndrome.

Conclusions:

  • Adjunctive corticosteroids offer specific benefits in certain tuberculosis forms, particularly in HIV-1 negative patients.
  • Careful consideration of HIV status and antiretroviral therapy is crucial due to potential harms.
  • Corticosteroids are valuable in managing the paradoxical reactions of HIV-tuberculosis immune reconstitution inflammatory syndrome, warranting further research into optimizing their use.